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PAINTasp ect Inspection Date: 08/28/2006 Inspector: Grande, Claudio Owner: Job Address: Project: ... III,._ 4 f ` MOYER, GORDON 54 99 Street NE Miami Shores Village, FL 33138- <NONE> Contractor: HOME OWNER Building Department Comments Friday, August 25, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Paint Inspection Type: Final Work Classification: New Phone Number (305)758 -4893 Parcel Number 1132060131070 Lot: Page 1 of 2 Passed Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until asp ect Inspection Date: 08/28/2006 Inspector: Grande, Claudio Owner: Job Address: Project: ... III,._ 4 f ` MOYER, GORDON 54 99 Street NE Miami Shores Village, FL 33138- <NONE> Contractor: HOME OWNER Building Department Comments Friday, August 25, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Paint Inspection Type: Final Work Classification: New Phone Number (305)758 -4893 Parcel Number 1132060131070 Lot: Page 1 of 2 i>>1 PERMIT APPLICATION � FBC 2004 L Y. BUILDING Permit Type (circle). Owner's Name (Fee Simple Titleholder) 1 4/4 E3/1/Jo /ee T dsr Phone # Owner's Address 54 , J. £ 9977 Sr City /Yli,n,i S State ,4C Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name cleNi /1l0 >W2- Contractor's Address 55'eo, /Ve /2. ,w 2 City /4,4,., State .4 Zip 3 3/3 ? Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Type of Work: ❑Addition ❑Alteration Describe Work: /". n 4vNr kieTL/Lio.A 0 ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *F Structural Review. $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Elec rfcal Plumbing County Miami -Dade Zip 3 NO X Training/Education Fee $ 0 .2-C Zip 33 /3 3 Permit No. Master Permit No. Phone # Mechanical Phone # 3J S — 7-16 Square / Linear Footage Of Work: Submittal Fee $ Permit Fee $ 620 Notary $ 3- OD Scanning $ Radon $ DPBR $ , Bond $ Code Enforcement $ Double Fee $ ❑ Repair/Replace ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Total Fee Now Due $ icy 1 ]- 9 Roofing ❑ Demolition CCF $O •:)C.D CO /CC Technology Fee $ 1 • Zoning $ See Reverse side -* Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) f1/- Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS. and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The fore oing instrument was acknowledged before me this � The foregoing instrument was acknowledged before me this day of , ('C-,( day of 20 b Y , _ , by who is personally known to me or who has produced who is personally known to me or who has produced I As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: APPLICATION APPROVED BY: (Revised 02/08/06) NOTARY PUBLIC: '_ice 6(L Sign: Print: My Commiss on Expire ' " `''''� ioi oll y i)D476 * * * * * * ** * * * * * * * ** �, ` ;A4444.43, c a.******************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Sign: Print: My Commission Expires: qAc Plans Examiner Engineer Zoning Date /2.0, 6 , A, Owner's Name �ita0 /u CSI T/!JS' Phone # 3c SW" 7 Owner's Address Sys `V 99' Sr City,?ij. 67-(0.1-4-s State A-c.- . Zip 33/3x? Job Address (where the work is being done) 991 Sr City Miami Shores Village County Miami -Dade Zip 33/3? Is Building Historically Designated YES NO pt,(p Phone # f 7 2 - -fSi3 Name Contractor's Company (if applicable)' ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Walls 8onrE' (a) /4/ Fascia Drip Cap /drip Edge Soffit Roof Flower bins Shutters Awnings Chimney Doors and door jams Garage doors Railings Fences Decorative metal All brick (simulated or regular) Any other stucco features . Accessory Buildings / 3 t,, W/ ' r Stucco banding Other OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Signature APPLICATION APPROVED BY: Miami Shores Village Paint Color Approval and Agreement i 8 bone white springfield tan Date VOI/o CO ZP Date clic 6/18/03 Issue Date: 6/29/2006 Owner's Name: GORDON MOYER Perm it Type: Paint Work Classification: New Job Address: 54 99 Street NE Comments: EXTERIOR PAINTING Additional Information Miami Shores Village, FL 33138- Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 12/26/2006 Contractor(s) Phone Primary Contractor HOME OWNER Yes Type of Work: Exterior Color: BONE WHITE AND SPRINGFIELD TAN Additional Info: Classification: Residential In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Parcel #: Block: Section: Permit Status: APPROVED Permit Number: PT -6 -06 -1759 Phone: (305)758 -4893 1132060131070 Lot: PB: Total Square Feet: Total Valuation: Required Inspections 0 $ 300.00 Final Fees Due CCF Education Surcharge Notary Fee Permit Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $60.00 $1.50 $67.30 Invoice Number PT - 6 - 06 - 25384 Total: Amt Due $67.30 Amt Paid $67.30 $67.30 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES . PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address S 4/LC / ? 57 Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant 645ie A i i b c, hr-2"" Master Permit # Owner's Address ,Sy /1/G Contracting Co. Qualifier State # Municipal # Signature of APPROVED: Zoning Mechanical Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): WORK DESCRIPTION 0. FEES: PERMIT / RADON Notary as to Owner and/ My Commission Exp BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING M S Se4 ?sue (2/ -AJ s- ,�/..v / �-S.� �, C-,�.P 1st" W ti .J ( �� /• I �^ .0 � 1�1 �� i/'v- S 71r�[ / cal /J � / ✓U 0 � Square Ft. t7 2 L� Estimated Cost (value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor o do the work stated. Building o � s S� _ G� CG 4,-,e v Address (l r C.C.F. S# Phone 757- /3.2 7 NOTARY Signature of Contractor or Owner - Builder ate /f D - ' P '2 O' -1 // Notary as to Contractor or Owner - Builder Date My Comnu� @ ion=E s 6- osa�. /� p �P !, gyp; RA Ca�^5FIC6 L 1 r /v7 p t . A � itl C O f7® t'9 C9 ' C r .Itf�. `171 .'1 1 ` Electrical k Phon In _ ZEE w,S BOND TOTAL DUE 8/1. Plumbing Engineering